Tesis

Perbandingan stimulasi antara rekombinan FSH dan HMG sebagai obat stimulasi ovarium terkontrol dengan luaran fertilisasi in vitro di klini melati RSAB Harapan Kita = Comparison of in vitro fertilization outcome with recombinant FSH or HMG as a drug used in the controlled ovarian stimulation at Melati Clinic, Harapan Kita Child and Mother Hospital.

Latar belakang: Infertilitas merupakan gangguan dalam sistem reproduksi berupa tidak tercapainya kehamilan secara klinis setelah hubungan seksual dilakukan secara reguler selama minimal 12 bulan tanpa menggunakan kontrasepsi. Salah satu pilihan tatalaksana adalah fertilisasi in vitro. Dalam melakukan FIV, salah satu tahap yang menunjang keberhasilan adalah stimulasi ovarium terkendali dengan menggunakan gonadotropin seperti rekombinan FSH atau human menopausal gonadotropin. Tujuan: Mengetahui hubungan stimulasi ovarium terkendali yang mendapatkan sediaan gonadotropin berupa rFSH dan hMG dengan luaran FIV berupa jumlah oosit, jumlah embrio, dan fertilization rate pada periode 2013– 2019 Metode: Penelitian ini menggunakan desain potong lintang menggunakan data rekam medis yang menjalani program FIV di Klinik Melati Harapan Kita tahun 2013 – 2019. Data yang digunakan adalah data pasien yang menjalani program dengan protokol rFSH dan hMG dibandingkan dengan luaran jumlah oosit, fertilization rate, dan jumlah embrio. Hasil: Dari 454 pasien yang memenuhi kriteria, 309 pasien menggunakan rFSH sebagai obat stimulasi ovarium dan 145 pasien menggunakan hMG sebagai obat stimulasi ovarium. Hasil uji non parametrik lebih tinggi pada kelompok pengguna rFSH dengan ketiga variabel yang diteliti ditemukan bermakana secara signifikan dengan hasil p < 0,05. Kesimpulan: Terdapat perbedaan yang signifikan antara jumlah oosit, fertilization rate, dan jumlah embrio pada kelompok rFSH dan hMG (P < 0,05) dengan rata-rata oosit, fertilization rate, dan jumlah embrio kelompok rFSH lebih besar daripada kelompok Hmg
Kata kunci: infertilitas; fertilisasi in vitro; stimulasi ovarium; rFSH; hMG.


Background: Infertility is a reproductive disorder characterized by inability of a married couple to be clinically pregnant after regular sexual intercourse of 12 months duration without using any contraceptive method. One of the therapeutic options to solve the problem is in vitro fertilization. Controlled ovarian stimulation is one of the most important steps which determine the success of the procedure. Gonadotropin has been used as the drug which stimulates the ovary to produce egg. Recombinant FSH and human menopausal gonadotropin are extensively used as the drug of choice. Aim: This research aimed to explore the relationship between gonadotropin which is used in the process of controlled ovarian stimulation, rFSH and hMG, and the in vitro fertilization outcome, which are oocyte number, embrio number, and fertilization rate during the period of 2013 – 2019. Methods: This research was a cross sectional study. Data from medical record of patients who underwent the in vitro fertilization procedure at Melati Clinic, Harapan Kita Child and Mother Hospital were obtained. This research collected the oocyte number, embryo number, and fertilization rate of eligible patients who received rFSH or hMG stimulation. Results: 454 patients were eligible for the research, further divided into 309 patients who received rFSH and 145 patients who received hMG. Non-parametric test revealed that patients who belong to the rFSH group had a statistically significant oocyte number, embryo number, and fertilization rate compared to hMG group with p < 0.05. Conclusion: Significant difference of oocyte number, embryo number, and fertilization rate exists between rFSH and hMG group (p < 0.05) with the mean oocyte number, embryo number, and fertilization rate are consistently observed higher in the rFSH group compared to hMG group.
Keywords: Infertility; in vitro fertilization; controlled ovarian stimulation; rFSH; hMG